Provider Demographics
NPI:1316363211
Name:SUTTIE, EMMA (DAC, AP)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:SUTTIE
Suffix:
Gender:F
Credentials:DAC, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-4940
Mailing Address - Country:US
Mailing Address - Phone:941-735-5940
Mailing Address - Fax:
Practice Address - Street 1:434 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-4940
Practice Address - Country:US
Practice Address - Phone:941-735-5940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-15
Last Update Date:2014-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3352171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist